Addressing Teen Pregnancy Using an Implementation Infrastructure

The Personal Responsibility Education Program (PREP) is one of the largest federally funded programs designed to address teen pregnancy. It provides $75 million a year to States that meet the following four requirements of their implementation infrastructure: programs must be evidenced based, provide information on abstinence and contraception, incorporate adulthood preparation subjects, and focus on high-risk populations. A report produced by the Office of Planning, Research and Evaluation focuses on the outcomes of four States funded by PREP: California, Maine, Pennsylvania, and South Carolina.

Researchers conducted semistructured telephone interviews with each State's PREP support staff, State grantee administrative staff, training and technical assistance partners, evaluators, and program providers. Despite each State's unique characteristics with regard to funding, program plans, and size, researchers determined that the States took similar approaches to supporting and implementing their evidence-based programs with fidelity.

Each of the four States included the following activities:

Contracting with at least one partner that had experience with training and technical assistance, as well as experience with teen pregnancy prevention and reproductive health programs. For example, California partnered with California Prevention Training Center.

Collaborating with their providers to align their content and delivery plans to the needs of targeted youth. For example, all States changed the language used in lessons and role-playing scripts to fit their populations.

Investing in developing, improving, and sustaining frontline facilitators' abilities to support the program by offering preservice as well as ongoing training. For example, the States used a train-the-trainer approach in which the program publisher trained the State grantee and partner organization staff who in turn trained the program facilitators.

Using data to monitor program delivery, quality, and training needs. For example, partner organizations conducted onsite provider visits during which staff observed and documented how facilitators provided the required lesson information, their comfort with the lesson content, and youth engagement.

The implications of these similarities are that the PREP implementation infrastructure may be replicated on a larger scale and across other programs or policy areas using key lessons learned from these four States, such as collaborating with expert partners and assessing how well the evidence-based programs fit the target population.

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